Laser Interstitial Thermal Therapy for Brain Tumors: A Prospective Multicenter Analysis of Patients From the LAANTERN Study

Abstract

PURPOSE Laser interstitial thermal therapy is a surgical tool used to ablate brain tumors, radiation necrosis, and epileptic foci. Data from the LAANTERN prospective multicenter registry (ClinicalTrials.gov identifier: NCT02392078 ), containing patients with tumor from 25 US centers between 2015 and 2023, were analyzed to determine clinical outcomes. METHODS All patients with primary or metastatic brain tumors treated with LITT using the Monteris NeuroBlate System were included in this analysis. Demographics, intraprocedural data, adverse events, survival data, and data pertaining to functional status over time were prospectively collected and then analyzed. Both univariable and multivariable analyses were performed. RESULTS A total of 787, primary (445) and metastatic brain tumor (342), patients were included. The median age was 59.6 years and the median pediatric age 15 years (n = 18). The median length of hospital stay was 32.4 hours, and 62.6% avoided intensive care unit admission. The adverse event rate was 12.8%, with 65.5% of events considered transient. Mortality rate was 0.25%. Anticonvulsants were stopped in 30%-40% of patients, and 80% of patients stopped steroids after LITT. Quality of life remained stable up to 3 years post-LITT. Greater extent of ablation (EOA) and smaller lesion size were associated with significant improvements in survival outcomes in patients with high-grade glioma and recurrent metastases. CONCLUSION The data from this largest, prospective LITT cohort support the consideration of LITT as a cytoreductive tool for patients with primary and metastatic tumor with short hospital stays, low complication rates, and preserved functional status. The EOA in glioblastoma and lesion volume in metastatic disease emerge as factors that may guide patient selection.